Isimila sesibeletho

Isigaxa se-pituitary ukukhula okungajwayelekile emgodini we-pituitary. I-pituitary iyindlala encane engxenyeni yobuchopho. Ilawula ukulingana komzimba kwamahomoni amaningi.

Izicubu eziningi zepituitary azinomdlavuza (benign). Kuze kube ngu-20% wabantu abanezicubu zepituitary. Eziningi zalezi zicubu azibangeli zimpawu futhi azikaze zitholwe ngesikhathi sokuphila komuntu.

I-pituitary iyingxenye yohlelo lwe-endocrine. I-pituitary isiza ukulawula ukukhishwa kwamahomoni kwezinye izindlala ze-endocrine, njenge-thyroid, izindlala zocansi (amasende noma ama-ovari), nezindlala ze-adrenal. I-pituitary iphinde ikhiphe ama-hormone athinta ngqo izicubu zomzimba, njengamathambo nezindlala zobisi lwebele. Ama-hormone e-pituitary afaka:

• Ihomoni ye-Adrenocorticotropic (ACTH)
• I-hormone yokukhula (GH)
• Iprolactin
• Ihomoni evuselela indlala yegilo (TSH)
• I-Luteinizing hormone (LH) ne-follicle-stimulating hormone (FSH)

Njengoba isimila se-pituitary sikhula, amaseli ejwayelekile akhipha ama-hormone we-pituitary angalimala. Lokhu kuholela ekutheni indlala yamapayipi ingakhiqizi ngokwanele amahomoni ayo. Lesi simo sibizwa ngokuthi yi-hypopituitarism.

Izimbangela zamathumba wesifuba azaziwa. Ezinye izicubu zidalwa yizinkinga zofuzo ezinjenge-endocrine neoplasia I (MEN I).

I-pituitary gland ingathinteka ezinye izicubu zobuchopho ezikhula engxenyeni efanayo yobuchopho (i-skull base), okuholele kwizimpawu ezifanayo.

Ezinye izicubu zepituitary zikhiqiza ihomoni eyodwa noma ngaphezulu kakhulu. Njengomphumela, izimpawu zesimo esisodwa noma eziningi zalezi ezilandelayo zingenzeka:

• I-Hyperthyroidism (indlala yegilo yenza amahomoni ayo amaningi, lesi yisimo esingajwayelekile kakhulu samathumba e-pituitary)
• I-Cushing syndrome (umzimba unezinga eliphakeme kunelejwayelekile le-hormone cortisol)
• I-Gigantism (ukukhula okungajwayelekile ngenxa yezinga eliphakeme kunelejwayelekile le-hormone yokukhula ngesikhathi sobuntwana) noma i-acromegaly (ephakeme kunezinga elijwayelekile le-hormone yokukhula kubantu abadala)
• Ukukhishwa kwengono kanye nokuya esikhathini okungajwayelekile noma okungekho kwabesifazane
• Ukwehla komsebenzi wezocansi emadodeni

Izimpawu ezibangelwa ingcindezi evela ku-pituitary tumor enkulu zingafaka:

• Izinguquko embonweni njengokubona kabili, ukulahleka kwenkundla okubukwayo (ukulahleka kombono), amajwabu amehlo alengayo noma izinguquko kumbono wombala.
• Ubuhlungu bekhanda.
• Ukungabi namandla.
• Umsele wamanzi oketshezi olucacile, olunosawoti.
• Isicanucanu nokuhlanza.
• Izinkinga ngomuzwa wokuhogela.
• Ezimweni ezingavamile, lezi zimpawu zivele ngokuzumayo futhi zingaba nzima (i-pituitary apoplexy).

Umhlinzeki wakho wokunakekelwa kwezempilo uzokwenza ukuhlolwa komzimba. Umhlinzeki uzobheka noma yiziphi izinkinga ngombono ophindwe kabili nensimu yokubuka, njengokulahleka kombono oseceleni (okuphathelene nomngcele) noma amandla okubona ezindaweni ezithile.

Ukuhlolwa kuzohlola izimpawu ze-cortisol eningi kakhulu (i-Cushing syndrome), i-hormone yokukhula eningi kakhulu (i-acromegaly), noma i-prolactin eningi kakhulu (i-prolactinoma).

Ukuhlolwa kokubheka ukusebenza kwe-endocrine kunga-oda, kufaka phakathi:

• Amazinga eCortisol - ukuhlolwa kokucindezela i-dexamethasone, ukuhlolwa kwe-cortisol yomchamo, ukuhlolwa kwe-salivary cortisol
• Izinga le-FSH
• Izinga le-insulin factor-1 (IGF-1) level
• LHlevel
• Izinga leprolactin
• Amazinga we-Testosterone / estradiol
• Amazinga ama-hormone wegilo - ukuhlolwa kwe-T4 kwamahhala, ukuhlolwa kwe-TSH

Ukuhlolwa okusiza ukuqinisekisa ukuxilongwa kufaka okulandelayo:

• Izinkambu ezibukwayo
• I-MRI yekhanda

Kuhlinzwa kaningi ukuhlinza isisu, ikakhulukazi uma isimila sicindezela izinzwa ezilawula ukubona (izinzwa ze-optic).

Isikhathi esiningi, izicubu zepituitary zingasuswa ngokuhlinzwa ngamakhala nangezono. Uma isimila singeke sisuswe ngale ndlela, sikhishwa ngogebhezi.

Ukwelashwa ngemisebe kungasetshenziselwa ukunciphisa isimila kubantu abangakwazi ukuhlinzwa. Ingasetshenziswa futhi uma isimila sibuya ngemuva kokuhlinzwa.

Kwezinye izimo, imithi inqunyelwe ukunciphisa izinhlobo ezithile zezicubu.

Lezi zinsizakusebenza zinganikeza imininingwane ethe xaxa ngezicubu zepituitary:

• Isikhungo Somdlavuza Kazwelonke - www.cancer.gov/types/pituitary
• IPituitary Network Association - pituitary.org
• I-Pituitary Society - www.pituitarysociety.org

Uma isimila singasuswa ngokuhlinzwa, umbono ulungile kokuhle, kuya ngokuthi sonke isimila sisusiwe yini.

Inkinga enkulu kakhulu ukungaboni. Lokhu kungenzeka uma inzwa ye-optic ilimele kakhulu.

Isimila noma ukususwa kwaso kungadala ukungalingani kwamahomoni impilo yonke. Ama-hormone athintekile angadinga ukushintshwa, futhi kungadingeka ukuthi uphuze umuthi impilo yakho yonke.

Izimila nokuhlinzwa kwesinye isikhathi kungalimaza i-posterior pituitary (ingxenye engemuva yendlala). Lokhu kungaholela kusifo sikashukela i-insipidus, isimo esinezimpawu zokuchama kaningi nokoma ngokweqile.

Shayela umhlinzeki wakho uma uba nezimpawu zesimila sepituitary.

Isimila - pituitary; I-pituitary adenoma

• Izindlala ze-Endocrine
• Indlala yamapayipi

UDorsey JF, uSalinas RD, uDang M, et al. Umdlavuza wesistimu yezinzwa emaphakathi. Ku: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, abahleli. I-Abeloff’s Clinical Oncology. Umhlaka 6. IPhiladelphia, PA: Elsevier; 2020: isahluko 63.

I-Melmed S, i-Kleinberg D. Izixuku zamapayipi nezicubu. Ku: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, abahleli. Incwadi kaWilliams ye-Endocrinology. Umhlaka 13. IPhiladelphia, PA: Elsevier; 2016: isahluko 9.